The nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which individuals are at risk of developing urinary obstructions? (Select all that apply).
A 69 year old female with anemia secondary to insufficient erythropoietin production
A 70 year old male with benign prostatic hyperplasia (BPH)
A 58 year old male with renal calculi
A 29 year old female, pregnant for the first time
Correct Answer : B,C,D,E
A. A 69-year-old female with anemia secondary to insufficient erythropoietin production: While anemia can occur due to chronic kidney disease, it does not directly cause urinary tract obstruction. The lack of erythropoietin affects red blood cell production, not urine flow.
B. A 70-year-old male with benign prostatic hyperplasia (BPH): BPH is a common cause of urinary obstruction in older men. The enlarged prostate compresses the urethra, leading to impaired urine outflow and increased risk of urinary retention.
C. A 58-year-old male with renal calculi: Kidney stones are a frequent cause of urinary tract obstruction. They can block the flow of urine in the ureters, renal pelvis, or bladder, leading to pain, hydronephrosis, and infection risk.
D. A 29-year-old female, pregnant for the first time: Pregnancy can cause urinary obstruction due to the enlarged uterus compressing the ureters, especially in the second and third trimesters, resulting in reduced urine flow and potential hydronephrosis.
E. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury: Neurogenic bladder disrupts normal bladder function and control, which can lead to urinary retention and obstruction due to poor coordination of bladder muscle and sphincter activity.
F. A 43-year-old male with an acid-base imbalance secondary to malnutrition: While malnutrition can affect many organ systems, acid-base imbalance by itself is not a direct cause of urinary tract obstruction.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","G"]
Explanation
A. Transient Ischemic Attack (TIA): A TIA presents with stroke-like symptoms that resolve within minutes to hours without permanent damage. Ms. Lauren’s symptom resolution within 6 hours and return to baseline strongly suggests a TIA. Prompt recognition is essential, as TIAs are often precursors to future strokes and require further evaluation.
B. Hemorrhagic Stroke: Hemorrhagic strokes typically present with sudden, severe symptoms such as intense headache, vomiting, or rapid loss of consciousness. These symptoms usually do not resolve quickly. Ms. Lauren’s gradual symptom resolution and stable vital signs are not consistent with this type of stroke.
C. Severe vision loss in both eyes: While visual disturbances can occur during strokes, bilateral severe vision loss is less common and would typically be seen in strokes involving the occipital lobes or vertebrobasilar system. Ms. Lauren’s case does not provide evidence of this symptom, hence an unlikely feature here.
D. Sudden loss of consciousness: Loss of consciousness is more common in massive strokes, particularly hemorrhagic ones or those involving the brainstem. Ms. Lauren remained awake and was able to report symptoms and anxiety, which rules out this presentation.
E. Sudden severe headache with vomiting: This symptom combination is more typical of a hemorrhagic stroke or subarachnoid hemorrhage. Ms. Lauren did not report a headache or vomiting, which makes this an unlikely symptom in her current presentation.
F. Ischemic Stroke: Ischemic strokes result in prolonged neurological deficits lasting more than 24 hours. Since Ms. Lauren’s symptoms are resolving within a short window and she is returning to baseline, this is less likely than a TIA in her situation.
G. Sudden weakness or numbness, often on one side of the body: This is a hallmark sign of a TIA or stroke. Ms. Lauren’s initial symptoms were stroke-like and likely included unilateral weakness or numbness, which are classic indicators of a TIA.
Correct Answer is A
Explanation
A. Esophageal: Esophageal variceal bleeding is the most common and serious complication of portal hypertension. Increased pressure in the portal venous system leads to the formation of varices in the esophagus, which can rupture and cause life-threatening hemorrhage.
B. Intestinal: While portal hypertension can cause changes in intestinal blood flow, it is not the most common site for clinically significant bleeding. Intestinal bleeding related to portal hypertension is much less frequent than esophageal variceal bleeding.
C. Duodenal: Duodenal bleeding is more commonly associated with peptic ulcer disease rather than portal hypertension. It is not a typical manifestation of increased portal venous pressure.
D. Rectal: Rectal bleeding may occur due to hemorrhoids or portal hypertensive colopathy, but it is less common and less life-threatening compared to esophageal varices in portal hypertension.
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